Abstract
BackgroundClostridium difficile (C. difficile) infection is an important cause of healthcare-associated diarrhea. Several factors such as admission of colonized patients, levels of serum antibodies in patients, and control strategies may involve in determining the prevalence and the persistence of C. difficile in a hospital unit.MethodsWe develop mathematical models based on deterministic and stochastic frameworks to investigate the effects of control strategies for colonized and symptomatic patients and admissions of colonized and symptomatic patients on the prevalence and the persistence of C. difficile.ResultsOur findings suggest that control strategies and admissions of colonized and symptomatic patients play important roles in determining the prevalence and the persistence of C. difficile. Improving control of C. difficile in colonized and symptomatic patients may generally help reduce the prevalence and the persistence of C. difficile. However, if admission rates of colonized and symptomatic patients are high, the prevalence of C. difficile may remain high in a patient population even though strict control policies are applied.ConclusionControl strategies and admissions of colonized and symptomatic patients are important determinants of the prevalence and the persistence of C. difficile.
Highlights
Clostridium difficile (C. difficile) infection is an important cause of healthcare-associated diarrhea
When the normal gut flora of patients is disrupted to conditions that favor proliferation of C. difficile, those who are exposed to C. difficile spores or those who are already asymptomatically colonized may develop C. difficile infection (CDI) [7, 8]
We develop mathematical models to investigate the effects of additional control measures targeted at colonized and infected patients and admissions of colonized patients on the prevalence of C. difficile and the tendency of infection cases to be temporarily driven out
Summary
Clostridium difficile (C. difficile) infection is an important cause of healthcare-associated diarrhea Several factors such as admission of colonized patients, levels of serum antibodies in patients, and control strategies may involve in determining the prevalence and the persistence of C. difficile in a hospital unit. Clostridium difficile (C. difficile) which is a spore-forming gram-positive bacillus is a causative agent of C. difficile infection (CDI). It has become a leading cause of healthcareassociated diarrhea resulting in morbidity, mortality, and hospitalized costs to patients and healthcare institutions in many countries [1]. When the normal gut flora of patients is disrupted to conditions that favor proliferation of C. difficile, those who are exposed to C. difficile spores or those who are already asymptomatically colonized may develop CDI [7, 8]. Note that despite the considerably lower rate in comparison to hospitalized patients, low-risk populations such as individuals with no recent health-care histories, pregnant women, and children in a community setting can develop CDI [10, 11]
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